Promoter hypermethylation and downregulation of the follistatin like-1 (FSTL-1) glycoprotein was associated with metastatic activity of nasopharyngeal carcinomas and dysfunction of macrophages, whereas treatment with recombinant human FSTL-1 protein elevated IL-1β and tumor necrosis factor-α in TAMs and repressed cancer cell immune evasion [230]. Here, FSTL1 is linked to nasopharyngeal carcinoma.